Trump's Executive Order on Gender-Affirming Healthcare
President Donald Trump has issued an executive order targeting gender-affirming healthcare for transgender Americans under the age of 19. The order labels such care as "mutilation" and directs federal agencies to take action to end it.
The order specifically targets the prescription of puberty blockers, hormone therapies, and affirming surgeries for individuals under 19. It also calls for blocking federal funding to medical schools and institutions that support affirming care.
This latest action follows a series of executive orders targeting transgender, nonbinary, and intersex Americans. These include a Department of Defense policy that could see the removal of thousands of trans service members, as well as changes throughout the federal government that effectively erase recognition of trans people.
Major medical organizations, including the American Academy of Pediatrics, the American Medical Association, and the American Academy of Child and Adolescent Psychiatry, stress that affirming healthcare guidelines are clinically appropriate for trans youth experiencing gender dysphoria. Medical guidelines generally say that affirming surgeries should only be approved for people ages 18 and older, and they are rarely if ever performed.
LGBT+ advocacy groups have been expecting and bracing for this order following Trump's campaign rhetoric and the rise of anti-trans proposals in state legislatures. They argue that the order is a dangerous attempt to put politicians between people and their doctors, preventing them from accessing evidence-based healthcare. They also emphasize that questions about this care should be answered by doctors, not politicians, and decisions must rest with families, doctors, and the patient.
Trump's order also singles out the World Professional Association for Transgender Health and its Standards of Care as lacking "scientific integrity." The Department of Justice is tasked with investigating affirming care providers and enforcing laws against "deceptive practices," according to the order.
Gender-affirming care will also be "excluded" from the Defense Department's TRICARE program, which provides care for nearly 2 million Americans under 18.
The Supreme Court is currently deciding whether laws that bar trans children from medically recommended healthcare qualify as unconstitutional sex discrimination under the 14th Amendment's equal protection clause. During oral arguments in December, conservative justices suggested that they would leave a decision on care standards for trans youth to individual states, echoing similar arguments from their landmark ruling that revoked a constitutional right to abortion care.
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